The Impact of Price Subsidies on Child Health Care Use : Evaluation of the Indonesian Healthcard

Financial barriers to seeking care are frequently cited as one of the main causes of underutilization of child health care services. This paper estimates the impact of Indonesia's healthcard on health care use by children. Evaluation of the healthcard effect is complicated by the fact that card allocation was non-random. The analysis uses propensity score matching to control for systematic differences between treatment and control groups. A second potential source of bias is related to contemporaneous, exogenous influences on health care use unrelated to the healthcard itself. Using panel data collected prior to and after the introduction of the healthcard, a difference-in-differences estimator is constructed to eliminate the effects of exogenous changes over time. The author finds that although health care use declined for all children during the crisis years of 1997-2000, use of public sector outpatient services declined much less for children with healthcards. The protective effect of the healthcard on public sector use was concentrated among children aged 0-5 years. The healthcard had no significant impact on use of private sector services. The results highlight the need to provide adequate protection against the financial burden of health care costs, particularly during economic crises.

Bibliographic Details

Main Author:	Somanathan, Aparnaa
Language:	English
Published:	World Bank, Washington, DC 2008-05
Subjects:	ACCESS TO HEALTH CARE, AGE GROUPS, BASIC HEALTH SERVICES, CAPITAL INVESTMENTS, CARE FOR CHILDREN, CATASTROPHIC HEALTH EXPENDITURE, CHILD HEALTH, CHILD HEALTH CARE, CHILD HEALTH SERVICES, COMMUNITIES, CONTRACEPTIVES, CULTURAL CHANGE, DEBT, DEMAND FOR HEALTH, DEMAND FOR HEALTH CARE, DEMAND FOR HEALTH SERVICES, DESCRIPTION, DETERMINANTS OF HEALTH, DEVELOPING COUNTRIES, DISTRICTS, DRINKING WATER, DRUGS, ECONOMIC DEVELOPMENT, ECONOMIC REVIEW, ECONOMIC STATUS, ECONOMICS OF HEALTH, EQUITY IN ACCESS, FAMILIES, FAMILY MEMBERS, FAMILY PLANNING, FAMILY PLANNING PROGRAM, FAMILY RESOURCES, FEMALE, FEMALES, FINANCIAL BARRIERS, GENDER, GENDER DIFFERENCES, HEALTH CARE, HEALTH CARE COSTS, HEALTH CARE DEMAND, HEALTH CARE FINANCING, HEALTH CARE PROVIDERS, HEALTH CARE SERVICES, HEALTH CARE USE, HEALTH CARE UTILIZATION, HEALTH CENTERS, HEALTH CENTRE, HEALTH ECONOMICS, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH FINANCING, HEALTH INSURANCE, HEALTH OUTCOMES, HEALTH POLICY, HEALTH PROVIDERS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE UTILIZATION, HEALTH SERVICES, HEALTH STRATEGY, HEALTH SYSTEM, HEALTH SYSTEMS, HOSPITAL, HOSPITALS, HOUSEHOLD BUDGETS, HOUSEHOLD LEVEL, HOUSEHOLD SIZE, HOUSEHOLDS, HOUSING, HUMAN CAPITAL, HUMAN DEVELOPMENT, HUMAN RESOURCE DEVELOPMENT, ILLNESS, IMPACT ON HEALTH, INCOME, INCOME ELASTICITIES, INCOME ELASTICITIES OF DEMAND, INCOME GROUPS, INFANT, INPATIENT CARE, INSURANCE, INSURANCE COVERAGE, INSURANCE SCHEMES, INTERVENTION, INTERVENTIONS, JOB TRAINING, LABOUR MARKET, LACK OF INFORMATION, LACK OF KNOWLEDGE, LIVING CONDITIONS, LIVING STANDARDS, LOCAL AUTHORITIES, LOCAL HEALTH CENTERS, LOW INCOME, MATERNAL HEALTH, MEDICAID, MEDICAL CARE, MEDICAL CARE DEMAND, MEDICAL CARE FOR THE POOR, MEDICAL SERVICES, MEDICAL STAFF, MEDICINES, MIDWIFE, MIDWIVES, MODERN CONTRACEPTION, MODERN CONTRACEPTIVE METHODS, MODERN HEALTH CARE, MORTALITY, NATIONAL FAMILY PLANNING, NEIGHBORHOOD, NUMBER OF CHILDREN, NUTRITION, OUTPATIENT CARE, OUTPATIENT SERVICES, PACIFIC REGION, PATIENTS, PHARMACIES, PHARMACISTS, PHARMACY, PILL, POCKET PAYMENTS, POCKET PAYMENTS FOR HEALTH CARE, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POOR FAMILIES, POOR HOUSEHOLDS, POOR QUALITY CARE, POVERTY ALLEVIATION, PRE-NATAL CARE, PRICE ELASTICITIES, PRICE ELASTICITY, PRIMARY CARE, PRIMARY HEALTH CARE, PRIMARY HEALTH CARE SERVICES, PRIMARY HEALTH SERVICES, PRIMARY SCHOOL, PRIMARY SCHOOLING, PRIVATE CARE, PRIVATE HEALTH CARE SERVICES, PRIVATE HEALTH SERVICES, PRIVATE SECTOR, PRIVATE SECTORS, PROBABILITY, PROGRESS, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC PROVIDERS, PUBLIC SECTOR, PURCHASING POWER, QUALITY OF SERVICES, RESOURCE ALLOCATION, RESPECT, RURAL AREAS, RURAL COMMUNITY, SAFETY, SAFETY NET, SCHOOL HEALTH, SERVICE DELIVERY, SERVICE PROVIDERS, SEX, SHOPS, SOCIAL SECURITY, SOCIAL SERVICES, SOCIOECONOMIC STATUS, TV, UNEMPLOYMENT, URBAN AREA, URBAN AREAS, URBAN COMMUNITY, USE OF HEALTH SERVICES, USE OF MATERNAL HEALTH SERVICES, USER FEES, VACCINATION, VILLAGES, VULNERABLE GROUPS, YOUNG CHILDREN,
Online Access:	http://documents.worldbank.org/curated/en/2008/05/9456670/impact-price-subsidies-child-health-care-use-evaluation-indonesian-healthcard https://hdl.handle.net/10986/6682
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